Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $89.13 / $95.50	Facility	26	$85.11	$89.13	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $416.87	Professional		$134.90	$177.83	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $95.50 / $275.42	Professional	26	$56.23	$95.50	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $97.72 / $234.42	Professional	TC	$67.61	$97.72	$234.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $79.43 / $114.82	Professional	26	$51.29	$79.43	$114.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $186.21 / $199.53	Professional		$102.33	$186.21	$199.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $109.65 / $147.91	Professional	26	$109.65	$109.65	$147.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	TC	$91.20	$91.20	$91.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $91.20 / $162.18	Professional		$57.54	$91.20	$162.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $112.20	Facility	26	$16.98	$79.43	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $407.38	Professional		$112.20	$194.98	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $87.10 / $181.97	Professional	26	$51.29	$87.10	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $102.33 / $288.40	Professional	TC	$56.23	$102.33	$288.40
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $89.13 / $117.49	Facility	26	$72.44	$89.13	$117.49
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $371.54	Professional		$125.89	$173.78	$371.54
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $85.11 / $223.87	Professional	26	$51.29	$85.11	$223.87
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $95.50 / $218.78	Professional	TC	$67.61	$95.50	$218.78
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $112.20	Facility	26	$16.98	$79.43	$112.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $354.81	Professional		$109.65	$181.97	$354.81
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $72.44 / $151.36	Professional	26	$50.12	$72.44	$151.36
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $89.13 / $257.04	Professional	TC	$53.70	$89.13	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $316.23	Professional		$128.82	$165.96	$316.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $107.15	Professional	26	$52.48	$72.44	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $85.11 / $218.78	Professional	TC	$66.07	$85.11	$218.78